Evaluation of patients' laboratory results who applied for periodic health examination

Purpose: The purpose of this study was to determine the frequency of laboratory result anomalies of apparently healthy individuals who applied to the family medicine outpatient clinic for Periodic Health Evaluation(PHE) and diagnoses based on these results, to evaluate the consequences of tests ordered out of PHE intervals in the concept of quaternary prevention and overdiagnosis. Materials-Methods: This descriptive cross-sectional study was conducted through retrospective evaluation of the routine laboratory tests of non-pregnant, asymptomatic patients over the age of 18 who applied to the family medicine outpatient clinic of a university hospital between January 2017 and December 2018. Results: 1415 people were included in the study. The vast majority of patients were women (%75,5). The most common laboratory anomalies were; borderline Vitamin B12 deficiency (200-300pg/ml) in 524 people, Vitamin B12 deficiency (<200pg/mL) in 491 people, low ferritin (<30ml/ng) in 847 people, non-optimal LDL (>100mg/dL) in 876 people, Impaired Fasting Glucose in 236 people, 25-OH Vitamin D deficiency (<20ng/mL) in 890 people and insufficiency (20-30 ng/mL) in 361 people, high triglyceride (>150mg/dL) in 300 people and high total cholesterol (>200mg/dL) in 465 people. At least 1 laboratory abnormality was detected in all patients except 1 patient. Conclusion: General Health Examination with routine laboratory tests applied to patients without chronic diseases and complaints is not an effective and evidence-based method. It has negative effects on both the patient and the health system by causing inappropriate laboratory requests and interventions. Personalized PHE should be applied to patients according to their risk factors and sociodemographic characteristics. It is an important duty of family physicians, who know the patient closely and have the opportunity to follow up patients regularly, to prevent the mentioned harms with structured PHE. Also; the prevalence of iron deficiency, Vitamin B12 deficiency, 25-OH Vitamin D deficiency and dyslipidemia are quite high in apparently healthy individuals. Extensive prevalence studies are needed. There is a need for studies which will investigate whether the diagnosis and treatment of these deficiencies contribute to mortality and morbidity and the possible harms such as overdiagnosis, labeling and anxiety in patients.